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Canadian Journal of Anesthesia, Vol 30, 536-539, Copyright © 1983 by Canadian Anesthesiologists' Society

Succinylcholine Apnoea: Attempted Reversal with Anticholinesterases

DAVID R. BEVAN MB MRCP FFARCS1 and FRANCOIS DONATI PHD MD1

1 Departments of Anaesthesia, Royal Victoria Hospital & McGill University, Montreal, Quebec

Address correspondence to: Dr. David R. Bevan, Department of Anaesthesia, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Que., H3A 1A1.

Anticholinesterases were administered in an attempt to antagonize prolonged neuromuscular blockade following the administration of succinylcholine in a patient later found to be homozygous for arypical plasma cholinesterase. Edrophonium 10 mg, given 74 min after succinylcholine, when train-of-four stimulation was characteristic of phase II block, produced partial antagonism which was not sustained. Repeated doses of edrophonium to 70 mg and neostigmine to 2.5 mg did not antagonize or augment the block. Spontaneous respiration recommenced 200 min after succinylcholine administration. It is concluded that anticholinesterases are only partially effective in restoring neuromuscular function in succinylcholine apnoea despite muscle twitch activity typical of phase II block.

Key Words: NEUROMUSCULAR RELAXANTS: succinylcholine • COMPLICATIONS: apnoea • ANTAGONISTS, NEUROMUSCULAR RELAXANTS: neostigmine, edrophonium






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Copyright © 1983 by the Canadian Anesthesiologists' Society.